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HomeMedical Information CancerThe Possible Confusion in Diagnosing Cancer

The Possible Confusion in Diagnosing Cancer

2/26/2018 | By: Medix Team

Sometimes different pathologists reach different conclusions when analysing biopsies, which may affect the diagnosis of the disease, its manner of treatment and chances of recovery.

Mr E., aged 22, suffered from a fever for a few months and blood tests were unable to establish why. Imaging studies raised suspicion of a tumor in his abdominal cavity, an operation was performed to have it removed. During the operation, a tissue sample was taken from the operated area and the pathology study revealed that it was a rare aggressive tumor. His physicians scheduled another major operation for him to have the tumor completely removed, followed by chemotherapy. Being afraid and before agreeing to it, Mr E. approached Medix for personal medical case management. As the diagnosis is considered rare, particularly for his young age, Medix recommended to delay the operation and send the specimen to another pathologist, a specialist of global reputation from a leading cancer research medical center in the USA for a second opinion. In two days a different answer came back: it was not a tumor at all but an inflammatory process secondary to an inflammation in the body. This meant that only anti-inflammatory medication was needed and no surgery nor chemotherapy.

Today Mr E. is completely healthy.

 

Sometimes pathological opinions given to patients do not correspond with each other, which may affect the diagnosis, manner of treatment of the disease and odds of recovery.

 

In situations in which two different pathology opinions have been reached for the same patient, or in situations in which the oncologist believes that the pathology result does not correspond with the disease’s behavior, consultation by a multi-disciplinary team of specialists or a third pathological opinion is required.

 

It should be noted that in addition to confirming diagnosis of a cancer, it is important to use the pathology study to determine the biological and genetic characteristics of the tumors too, which dictate their behavior and their chances of reacting to a certain treatment.

 

In a study that was published in 2016 in Oral Oncology, researchers from Stanford University School of Medicine found histological (tissue characterization) disagreements between pathologists in 22% of head and neck cancer diagnoses that were referred for another pathological opinion (for example for examining biological and genetic characteristics of the tumor). In a study which was published in 2016 in the American Journal of Clinical Pathology, significant disagreement was found among pathologists for 16% of tissue specimens taken from cancer patients (for example for examining biological and genetic characteristics of the tumor). The most significant differences were in tumors of the spine and brain, which are considered complex and which require a decision on whether to treat them by irradiation, chemotherapy or surgery.

 

Medix, the leader in Personal Medical Case Management with over a decade of experience managing complex medical cases has reviewed the results of hundreds of pathology tests according to specific criteria. In 15% of the cases reviewed, Medix found the need to send the pathology tests for a second revision to world renowned centers of excellence. The results were unequivocal with over 40% of these resulting in a change in diagnosis of the disease, leading to a change in the proposed treatment plan.

 

Therefore Medix has defined new criteria for when pathology results should be sent to second and sometimes third medical review: 

  1. Rareness or complexity of the initial medical diagnosis
  2. Difficulty in reaching a decisive diagnosis – if the diagnosis is not clear or is borderline or if there are a number of possible diagnosis
  3. Lack of correlation between the clinical results and the imaging/pathological results
  4. Initial pathology analysis was performed in a centre with a lack of experience of histopathology in the specific areas being diagnosed

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